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After Your Lung Surgery

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After Your Lung Surgery After your lung surgery Department of thoracic surgery Information for Patients i Leaflet number: 257 Version: 2.1 Produced: Feb 2019 Review: Oct 2021 Introduction This booklet aims to explain: What to expect when you return home to recover after your surgery What is considered ‘normal’ and when to seek help Where to go for advice or support after you go home (discharge) Being discharged home Whilst in hospital you will have a daily review from our doctors. This is usually during a morning ward round. The doctors will explain when you are medically fit to go home- this will usually happen later that same day. Please note that most discharges do not happen until the afternoon. This gives us time to make sure everything is ready for you to have a safe discharge Once the doctor has completed the paperwork for your discharge, any medication you need will be ordered from the hospital pharmacy. The hospital pharmacy can be very busy. They do try to give medications quickly, but you may have a 2-4 hour wait. Once your discharge has been confirmed, you may be asked to leave the ward and go to the discharge lounge at Glenfield Hospital. This is an area where patients can wait for their family or friends to collect them. The staff in the discharge lounge can give you any medication that you require. Whilst there please ask the staff should you need anything to keep you comfortable. If you are in employment, please ask your doctor how long you should expect to be off work 2 You will be given: Medication and letters for your GP and/ or community nurse if you need stitches or clips removing. A copy of this will also be posted to your GP. Sometimes patients go home with a chest drain. If this happens, you will be given the chest drain information and equipment. Further information can be found on pages 13-15 of this booklet. A spare pair of stockings, if required. These should be worn to help prevent blood clots in your legs (also known as deep vein thrombosis). These should be worn for six weeks or until your mobility is back to your normal level. Please ask for a ‘fitness to work’ certificate if you need one before leaving the ward. Getting out and about/ exercising Most patients will be worried about going home – your confidence will soon return. It is very important that you keep active following lung surgery. The worst thing you can do following your discharge home is take to your bed and not be mobile. This increases the risk of post operative complications such as chest infections, deep vein thrombosis and pressure sores. You should get up and go to bed at your normal time. Have an afternoon nap if required, but for no longer than one hour. Set an alarm to wake you up. Do not stay in your bed. Even if sat upright in bed your lungs do not expand properly and the risk of complications such as chest infections increases. 3 Getting out and about/ exercising Aim for a brisk walk, twice a day, gradually increasing distance and pace. You should aim to feel a little short of breath (able to walk and talk). This level of exercise will help your recovery without making you too tired. Get out and about. Often patients can feel low in mood after surgery so it is important to spend time with your family and friends. Go shopping with family or friends, lean on the trolley if you need to! Remember that we are all individuals and all heal at different rates. Aim to get back to your normal levels of activity within around six weeks of surgery. Looking after yourself By the time you go home you will be able to wash and dress yourself. You will be walking around the ward and hospital. Ladies: bras can be uncomfortable for a while. Non-wired bras tend to be more comfortable while your wounds are healing. You can cook but avoid lifting heavy pots or pans. Ready meals are often ideal for the first few days after going home. Light dusting is acceptable, but avoid vacuuming or moving heavy objects for several weeks until you can carry out these movements without significant discomfort. Some shortness of breath is to be expected - this will depend on the type of surgery you have had and your general fitness. 4 Looking after yourself (continued) Remember to keep as mobile as you can to aid your recovery. It is okay to go up and down stairs, and go out for walks even when the weather is cold - just wrap up warmly. You need to be slightly breathless when exercising/being mobile. This proves that you are working hard enough! It will help your lung to fully expand and will reduce the risk of chest infections. Rebuild your stamina/endurance to what is normal for you – this isn’t always a quick process and can take weeks or months. Pain or discomfort You should expect to have some soreness but you should not be in so much pain that your day-to-day activities are restricted. Being active reduces the risks of chest infection, pressure sores and blood clots. Patients often report some numbness or change in feeling (sensation) to the front of the chest on the side of their surgery. This is normal and relates to the nerve pathways under the ribs. It is normal to experience shooting or stabbing pains as any nerves damaged at the time of surgery repair themselves. These sensations can last for several months. You should take your painkillers as prescribed. Paracetamol should be the last painkiller to be stopped. Paracetamol is very effective if you take two tablets, four times a day. Please contact the Thoracic Nurse Specialists if you need advice about reducing your painkillers. You can also ask the doctors at your follow-up appointment. Your painkillers are highly likely to make you constipated. You must take the laxatives prescribed for you - usually Lactulose or Senna. They only work if taken regularly. 5 Eating and drinking Sometimes appetite is reduced after an operation and you may lose some weight. You should try to eat small meals that contain more calories than you would normally eat. You can achieve this by including full-fat milk, spreads and high calorie additions to your normal diet. Bowels Drink plenty of water. Eating two to three pieces of fruit and three portions of vegetables a day can help reduce constipation. Consult your GP if this problem carries on. Looking after your wounds Try not to touch the wounds, this helps to reduce the risk of infection. Your wound should be left without dressings if clean and dry. This will help it heal more quickly. You can shower but do not scrub the wound and avoid using perfumed products until completely healed. If having a bath please do not sit with the wound submerged in water as this can delay healing. You may have stitches (sutures) or clips that need to be removed by the practice nurse at your local GP surgery. The nurses on the ward will give you a letter and a date for these to be removed. These stitches are normally removed seven to ten days after drain removal. The scabs from the chest drain site can take several weeks to fall off. Please do not pick them as doing so may cause infection. 6 Stockings You may have been given special stockings to wear after surgery. These help to improve circulation and reduce the risk of developing blood clots in your legs – this is known as deep vein thrombosis or DVT. You should wear the stockings until you return to your normal level of activity, usually up to six weeks after you have gone home. You should wear these day and night and ask for a spare pair to allow for washing. Posture and shoulder movement Try and maintain an upright position – you can check how upright you are in a mirror. Gentle side stretches away from your operated side may help your posture. Keep your shoulders moving. If you have shoulder movement problems that don’t go away ask your surgeon or GP for a physiotherapy assessment. Emotions Any sort of operation can affect people emotionally and mentally, so it is usual to have feelings of anxiety or depression. Try talking about your feelings; remember your friends and family need to talk things over as well. Try to have realistic goals. Remember you can telephone the thoracic nurse specialists if you are finding this difficult. 7 Sex Sexual relationships can be resumed when your wounds are healed, within the limits of your comfort and when you and your partner are ready. This may take several weeks. Remember your partner may be worried about hurting you. Try taking a more passive role. Driving, work and flying Driving It is essential that you can perform an emergency stop without pain when you start driving again. This can vary from two to six weeks after surgery. We recommend that you discuss when you can start driving again with the doctor at your outpatient check up or with your GP. Remember to inform your insurance company that you have undergone chest surgery. This should not affect your policy, but if you do not phone to check it could affect your insurance cover. Work Please ask the medical staff for advice at your outpatient check up or discuss with your GP. You can return to work when you feel well and comfortable.
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